Dose escalation intensity-modulated radiotherapy-based concurrent chemoradiotherapy is effective for advanced-stage thoracic esophageal squamous cell carcinoma

Chia Lun Chang, Hsieh Chih Tsai, Wei Cheng Lin, Jer Hwa Chang, Han Lin Hsu, Jyh Ming Chow, Kevin Sheng Po Yuan, Alexander T.H. Wu, Szu Yuan Wu

研究成果: 雜誌貢獻文章

19 引文 (Scopus)

摘要

Purpose: No studies have investigated the effects of irradiation-dose escalation intensity-modulated radiotherapy (IMRT)-based concurrent chemoradiotherapy (CCRT) in patients with thoracic esophageal squamous cell carcinoma (TESCC). Patients and methods: We analyzed data from patients with TESCC who were enrolled in the Taiwan Cancer Registry database. To compare treatment outcomes, the patients were categorized into two groups according to their radiotherapy doses: group 1, who received CCRT. <. 60. Gy with IMRT, and group 2, who received CCRT. ≥. 60. Gy with IMRT. Group 1 was used as the control for investigating posttreatment mortality risk. Results: We enrolled 2061 patients with TESCC without distant metastasis who received CCRT with IMRT. Multivariate Cox regression analysis indicated that advanced clinical American Joint Committee on Cancer (AJCC) stage (≥IIIA), alcohol consumption, and cigarette smoking were significant, poor independent predictors in patients with TESCC receiving IMRT-based CCRT. IMRT-based CCRT (≥60. Gy; adjusted hazard ratio [aHR]: 0.75; 95% confidence interval [CI]: 0.63-0.83) was a significant independent prognostic factor for overall survival (P <. 0.0001). After adjustment for confounders, the aHRs (95% CIs) for overall mortality at all clinical stages were 0.75 (0.68-0.83, P <. 0.0001) in group 2. In group 2, the aHRs (95% CIs) for overall mortality at early (IA-IIB) and advanced (IIIA-IIIC) AJCC clinical stages were 0.89 (0.70-1.04, P = 0.1905) and 0.75 (0.67-0.83, P <. 0.0001), respectively. Conclusion: Compared with standard-dose IMRT-based CCRT, high-dose IMRT-based CCRT yields more favorable survival outcomes in patients with advanced-stage TESCC.
原文英語
期刊Radiotherapy and Oncology
DOIs
出版狀態接受/付印 - 2017

指紋

Intensity-Modulated Radiotherapy
Chemoradiotherapy
Thorax
Mortality
Neoplasms
Survival
Esophageal Squamous Cell Carcinoma
Taiwan
Alcohol Drinking
Registries
Radiotherapy
Smoking
Regression Analysis
Databases
Confidence Intervals
Neoplasm Metastasis

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Radiology Nuclear Medicine and imaging

引用此文

@article{35bd310bbc9a4f5495494cb1204e0538,
title = "Dose escalation intensity-modulated radiotherapy-based concurrent chemoradiotherapy is effective for advanced-stage thoracic esophageal squamous cell carcinoma",
abstract = "Purpose: No studies have investigated the effects of irradiation-dose escalation intensity-modulated radiotherapy (IMRT)-based concurrent chemoradiotherapy (CCRT) in patients with thoracic esophageal squamous cell carcinoma (TESCC). Patients and methods: We analyzed data from patients with TESCC who were enrolled in the Taiwan Cancer Registry database. To compare treatment outcomes, the patients were categorized into two groups according to their radiotherapy doses: group 1, who received CCRT. <. 60. Gy with IMRT, and group 2, who received CCRT. ≥. 60. Gy with IMRT. Group 1 was used as the control for investigating posttreatment mortality risk. Results: We enrolled 2061 patients with TESCC without distant metastasis who received CCRT with IMRT. Multivariate Cox regression analysis indicated that advanced clinical American Joint Committee on Cancer (AJCC) stage (≥IIIA), alcohol consumption, and cigarette smoking were significant, poor independent predictors in patients with TESCC receiving IMRT-based CCRT. IMRT-based CCRT (≥60. Gy; adjusted hazard ratio [aHR]: 0.75; 95{\%} confidence interval [CI]: 0.63-0.83) was a significant independent prognostic factor for overall survival (P <. 0.0001). After adjustment for confounders, the aHRs (95{\%} CIs) for overall mortality at all clinical stages were 0.75 (0.68-0.83, P <. 0.0001) in group 2. In group 2, the aHRs (95{\%} CIs) for overall mortality at early (IA-IIB) and advanced (IIIA-IIIC) AJCC clinical stages were 0.89 (0.70-1.04, P = 0.1905) and 0.75 (0.67-0.83, P <. 0.0001), respectively. Conclusion: Compared with standard-dose IMRT-based CCRT, high-dose IMRT-based CCRT yields more favorable survival outcomes in patients with advanced-stage TESCC.",
keywords = "Dose escalation, Intensity-modulated radiotherapy, Squamous cell carcinoma, Thoracic esophageal cancer",
author = "Chang, {Chia Lun} and Tsai, {Hsieh Chih} and Lin, {Wei Cheng} and Chang, {Jer Hwa} and Hsu, {Han Lin} and Chow, {Jyh Ming} and Yuan, {Kevin Sheng Po} and Wu, {Alexander T.H.} and Wu, {Szu Yuan}",
year = "2017",
doi = "10.1016/j.radonc.2017.08.025",
language = "English",
journal = "Radiotherapy and Oncology",
issn = "0167-8140",
publisher = "Elsevier Ireland Ltd",

}

TY - JOUR

T1 - Dose escalation intensity-modulated radiotherapy-based concurrent chemoradiotherapy is effective for advanced-stage thoracic esophageal squamous cell carcinoma

AU - Chang, Chia Lun

AU - Tsai, Hsieh Chih

AU - Lin, Wei Cheng

AU - Chang, Jer Hwa

AU - Hsu, Han Lin

AU - Chow, Jyh Ming

AU - Yuan, Kevin Sheng Po

AU - Wu, Alexander T.H.

AU - Wu, Szu Yuan

PY - 2017

Y1 - 2017

N2 - Purpose: No studies have investigated the effects of irradiation-dose escalation intensity-modulated radiotherapy (IMRT)-based concurrent chemoradiotherapy (CCRT) in patients with thoracic esophageal squamous cell carcinoma (TESCC). Patients and methods: We analyzed data from patients with TESCC who were enrolled in the Taiwan Cancer Registry database. To compare treatment outcomes, the patients were categorized into two groups according to their radiotherapy doses: group 1, who received CCRT. <. 60. Gy with IMRT, and group 2, who received CCRT. ≥. 60. Gy with IMRT. Group 1 was used as the control for investigating posttreatment mortality risk. Results: We enrolled 2061 patients with TESCC without distant metastasis who received CCRT with IMRT. Multivariate Cox regression analysis indicated that advanced clinical American Joint Committee on Cancer (AJCC) stage (≥IIIA), alcohol consumption, and cigarette smoking were significant, poor independent predictors in patients with TESCC receiving IMRT-based CCRT. IMRT-based CCRT (≥60. Gy; adjusted hazard ratio [aHR]: 0.75; 95% confidence interval [CI]: 0.63-0.83) was a significant independent prognostic factor for overall survival (P <. 0.0001). After adjustment for confounders, the aHRs (95% CIs) for overall mortality at all clinical stages were 0.75 (0.68-0.83, P <. 0.0001) in group 2. In group 2, the aHRs (95% CIs) for overall mortality at early (IA-IIB) and advanced (IIIA-IIIC) AJCC clinical stages were 0.89 (0.70-1.04, P = 0.1905) and 0.75 (0.67-0.83, P <. 0.0001), respectively. Conclusion: Compared with standard-dose IMRT-based CCRT, high-dose IMRT-based CCRT yields more favorable survival outcomes in patients with advanced-stage TESCC.

AB - Purpose: No studies have investigated the effects of irradiation-dose escalation intensity-modulated radiotherapy (IMRT)-based concurrent chemoradiotherapy (CCRT) in patients with thoracic esophageal squamous cell carcinoma (TESCC). Patients and methods: We analyzed data from patients with TESCC who were enrolled in the Taiwan Cancer Registry database. To compare treatment outcomes, the patients were categorized into two groups according to their radiotherapy doses: group 1, who received CCRT. <. 60. Gy with IMRT, and group 2, who received CCRT. ≥. 60. Gy with IMRT. Group 1 was used as the control for investigating posttreatment mortality risk. Results: We enrolled 2061 patients with TESCC without distant metastasis who received CCRT with IMRT. Multivariate Cox regression analysis indicated that advanced clinical American Joint Committee on Cancer (AJCC) stage (≥IIIA), alcohol consumption, and cigarette smoking were significant, poor independent predictors in patients with TESCC receiving IMRT-based CCRT. IMRT-based CCRT (≥60. Gy; adjusted hazard ratio [aHR]: 0.75; 95% confidence interval [CI]: 0.63-0.83) was a significant independent prognostic factor for overall survival (P <. 0.0001). After adjustment for confounders, the aHRs (95% CIs) for overall mortality at all clinical stages were 0.75 (0.68-0.83, P <. 0.0001) in group 2. In group 2, the aHRs (95% CIs) for overall mortality at early (IA-IIB) and advanced (IIIA-IIIC) AJCC clinical stages were 0.89 (0.70-1.04, P = 0.1905) and 0.75 (0.67-0.83, P <. 0.0001), respectively. Conclusion: Compared with standard-dose IMRT-based CCRT, high-dose IMRT-based CCRT yields more favorable survival outcomes in patients with advanced-stage TESCC.

KW - Dose escalation

KW - Intensity-modulated radiotherapy

KW - Squamous cell carcinoma

KW - Thoracic esophageal cancer

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